Drugs: World contemplates punishment or rehabilitation

We take a deep dive into what the top three parties' manifestos have to say about drugs policy. (Photo Credit: Kyla Herrmannsen)

abandoned new needlesFor the first time in 17 years, the United Nations has convened a special session on “the world drug problem” amid fierce international debate about whether drug users should primarily be punished or rehabilitated.

The UN General Assembly Special Session (UNGASS) on drugs, which runs from Tuesday until Thursday (19-21 April) was called after Mexico, Colombia and Guatemala appealed to the body to revise the global approach to illegal drugs.

[quote float = right]But South African policy on the ground is quite different. The TB/HIV Care Association (THCA) offers clean needles to drug users, but reported almost 250 cases of police harassment in just three months last year.

After nearly two decades – and a trillion or so dollars later – the “war-on-drugs” approach of criminalising drug users has failed to prevent the distribution and use of illegal drugs. Many countries and organisations are calling for the global approach to be tilted in favour of “harm reduction” strategies that help drug users to deal with their addiction rather than imprisoning them.

Harm reduction strategies include opioid substitution programmes, where injecting heroin users are offered oral methadone instead to help them to reduce their drug dependency, and needle exchanges, offering injecting drug users clean needles to reduce their chances of getting HIV and Hepatitis C.

But there is an almighty war about future policy in a world where a person can be executed in Indonesia for drug possession, but use the same drugs without imprisonment in Portugal and the Czech Republic.

South Africa has been pulled in different directions by the lobbying. Russia, a key advocate of the punitive approach, held a joint meeting with African countries in Durban recently in an attempt to sway this continent to support the punitive status quo.

Harm reduction

But it appears that the “harm reduction” approach adopted last year by the African Union (AU) may win the day. South Africa’s Deputy Social Development Minister, Hendrietta Bogopane-Zulu, has played an important role in promoting harm reduction as chairperson of the AU’s Technical Committee on Health, Population and Drug Control.

The AU Common Position emanating from this technical committee stresses a harm-reduction approach that is “evidence-informed, ethical and human rights-based” and offers “dependence treatment and after care services”.

At a meeting in Vienna last month, Bogopane-Zulu said: “I would strongly support an approach where drug users form their own network to discuss their problems, that they have focal points in police stations and at hospitals with whom they can interact on their concerns and very importantly, that religious and traditional leaders be trained alongside criminal justice system professionals on among others, harm reduction approaches”.

But South African policy on the ground is quite different. The TB/HIV Care Association (THCA) offers clean needles to drug users, but reported almost 250 cases of police harassment in just three months last year. Meanwhile, there is only one site in the entire country that offers opioid substitution for heroin dependant drug users.


Unfortunately, the “outcome document” negotiated prior to UNGASS makes no mention of harm reduction, and has been condemned by almost 200 civil society organisations headed by the International Drug Policy Consortium.

The Vienna meeting that prepared the outcome document was dominated by Russia, which takes a heavy-handed approach to drugs. Drug addiction is a huge and growing problem in Russia, which has an estimated eight million heroin users – approximately six percent of its population. Russia’s policies, such as their refusal to provide opioid substitution therapy or needle and syringe programmes, have been largely responsible for the massive increase in new HIV infections related to injecting drug use.

According to the civil society organisations, the draft outcome document’s goal of “a society free of drug abuse” by 2019 “is delusional and dangerous, framing and distorting the entire policy response, prioritising the elimination of drugs above health, well-being, human rights, and the reduction of drug-related harm”.

They say that if UNGASS endorses the current approach to drugs, it will be a huge waste of money as the current approach has caused a litany of problems including:

  • human rights abuses, including the death penalty for drug offences;
  • exacerbated HIV and hepatitis C transmission;
  • inadequate access to controlled drugs for medical purposes;
  • 187,000 avoidable drug-related deaths each year;
  • violence, corruption and killings perpetuated by criminal drug markets;
  • stigmatisation of people who use drugs;
  • destruction of subsistence farmers’ livelihoods by forced crop eradication.

Driving infection

Last month, a 22-person commission of experts convened by Johns Hopkins University and the medical journal, The Lancet, called for the decriminalisation of all non-violent drug use and possession.

The Hopkins-Lancet commission said drug prohibition was not evidence-based and was causing harm, namely:

  • Exacerbating violence between criminal networks and authorities: “In Mexico, the striking increase in homicides since the government decided to use military forces against drug traffickers in 2006 has been so great that it reduced life expectancy in the country.”
  • Driving infectious diseases, particularly in prisons: The “excessive use of incarceration as a drug control measure” brought drug users together in prisons where “HIV and hepatitis C virus transmission occurs among prisoners and detainees, and is often complicated by co-infection with tuberculosis”.
  • Displacing rural communities who produce crops of coca leaf, opium poppy, and cannabis, while the spraying of their crops with poisons had caused “respiratory and dermatological disorders and miscarriages”.
  • “Policies meant to prohibit or greatly suppress drugs … have contributed directly and indirectly to lethal violence, communicable-disease transmission, discrimination, forced displacement, unnecessary physical pain, and the undermining of people’s right to health,” concluded the commission.

UNGASS negotiations were largely completed at the 59th Session of the Commission in Narcotic Drugs, have been complicated and technical, and it is expected that the outcome document will be approved largely unchanged next week. However, there may be some opposition and calls for the insertion of two words – “harm reduction” – which will make a huge difference to people struggling with drug dependence as it will compel authorities to see them as people with a health problem rather than criminals. – Health-e News.

An edited version of this story also appeared in The Star and Cape Times newspapers


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